ARJO HUNTLEIGH First Step Plus User manual

First Step Plus
OPERATIONS MANUAL
P/N 200676-AH Rev A •09/2013 ...with people in mind

This First Step™ Plus Operations Manual is not a guarantee or warranty as to this product. It is intended only as a
service guide. For additional information, or for specific questions, please contact ArjoHuntleigh Customer Service.
In order for ArjoHuntleigh products to perform properly, the following conditions must be met. Failure to comply
with these conditions will void any pertinent warranties.
•All assembly, operation, adjustment, modification, maintenance and / or repair be carried out only by qualified
personnel authorized by ArjoHuntleigh.
•The electrical installation of the room must comply with the appropriate electrical wiring standards.
•The product must be used in accordance with this manual, this product’s Maintenance Manual and Quick
Reference Guide and all applicable labeling.
The only servicing to be carried out by the user is described in the Maintenance Chapter of the First Step Plus
Maintenance Manual.
Upon customer request and execution of any required confidentiality agreement, ArjoHuntleigh will make available,
circuit wiring diagrams, component parts lists, descriptions, calibration instructions or other information which
assist the user’s appropriately qualified personnel to repair those parts of the equipment designated by the
manufacturer as repairable.

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INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Contraindications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Risks and Precautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Maximum Patient Weight. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Safety Tips. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
PATIENT PLACEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
Preparing for Patient Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
Patient Transfer to First Step Plus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Ambulatory Patient Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Non-Ambulatory Patient Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3
Air Pressure Adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3
Completion of Patient Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-4
NURSING CARE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
CPR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Patient Transfer to First Step Plus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Patient Transfer from First Step Plus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Ambulatory Patient Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Non-Ambulatory Patient Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Patient Transport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
Patient Bathing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
Bedpan Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
Bedpan Removal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
Repositioning Patient Using Dri-Flo Underpads . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
Incontinence / Drainage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
Skin Care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
General Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
CARE AND CLEANING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
Daily Care and Cleaning of First Step Plus While in Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
Weekly Care and Cleaning of First Step Plus While in Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
OPERATING INSTRUCTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
Power-Up Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
Pressure Adjust . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
Warmer Adjust. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
SPECIFICATIONS* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1
QUESTIONS AND INFORMATION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1
TABLE OF CONTENTS

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1-1
1
INTRODUCTION
First Step Plus is a pressure-relieving mattress overlay designed to suspend a patient on a low-air-loss support
surface, providing effective pressure relief and early intervention for patients with skin breakdown.
First Step Plus Overlay is constructed of nylon fabric with moisture vapor permeable backing and is divided into
three sections: head, body and feet. The Air Supply Unit consists of a single constant speed blower with Warmer to
provide air temperatures that can be adjusted for each section of Overlay to meet individual patient needs.
INDICATIONS
First Step Plus is intended to help treat and reduce the incidence of pressure ulcers, while optimizing patient
comfort.
CONTRAINDICATIONS
Patient conditions for which the application of pressure relieving therapy on First Step Plus are contraindicated
include:
•unstable spinal cord injury
•unstable vertebral fracture
•cervical traction
RISKS AND PRECAUTIONS
•Transfer – Precaution should be taken during patient transfer, including locking of caster brakes and deflation
of Overlay surface. (Refer to Patient Transfer sections in the Patient Placement and Nursing Care chapters
of this manual.)
•Side Rails and Restraints – Use or non-use of restraints, including Side Rails, can be critical to patient safety.
WARNING: Serious injury or death can result from the use (potential entrapment) or non-use (potential patient
falls) of Side Rails or other restraints. (See related Safety Tips section.)
•Patient Migration –WARNING: Specialty surfaces have different shear and support characteristics than
conventional surfaces, and may increase risk of patient movement, sinking and / or migration into hazardous
positions of entrapment and / or inadvertent bed exit.
•Skeletal Traction or Unstable Fracture (if not contraindicated) –With unstable fractures or skeletal
traction, if not contraindicated, maintain physician-directed angle of articulation, and use care to guard against
risk of patient migration or inadvertent deflation of air surface.
•Oxygen Use – DANGER: Risk of explosion if used in the presence of Flammable Anesthetics. Use of this
product’s Air Supply Unit in an oxygen-enriched environment may produce potential of fire hazard. This
equipment is not suitable for use in the presence of a flammable anaesthetic mixture with air or with oxygen or
nitrous oxide.
CAUTION: Position Air Supply Unit only at foot-end of bed when using Oxygen Administering Equipment.
•Electromagnetic Interference – Although this equipment conforms with the intent of directive 89 / 336 / EEC
in relation to Electromagnetic Compatibility, all electrical equipment may produce interference. If interference is
suspected, move equipment away from sensitive devices or contact manufacturer.
•Shock Hazard – Electrical shock hazard; do not remove cover. Refer to Qualified Service Personnel.

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MAXIMUM PATIENT WEIGHT
•Maximum Patient Weight: 250 lb (114 kg).
SAFETY TIPS
Bed Frame – Always use standard healthcare bed frame with Side Rails and any other safeguards or protocols
that may be appropriate. Frame and Side Rails must be properly sized to eliminate any gaps that might entrap
patient’s head or body.
Brakes – Caster brakes should always be locked once bed is in position. Verify wheels are locked before patient
transfer to or from bed.
Bed Height – To minimize risk of falls or injury, bed should always be in lowest possible position when patient is
unattended.
Side Rails / Patient Restraints – Whether and how to use Side Rails or restraints is a decision that should be
based on each patient’s needs and should be made by the patient and the patient’s family, physician and
caregivers, with facility protocols in mind. Caregivers should assess risks and benefits of Side Rail restraint use
(including entrapment and patient falls from bed) in conjunction with individual patient needs, and should discuss
use or non-use with patient and / or family. Consider not only the clinical and other needs of the patient, but also
risk of fatal or serious injury from falling out of bed and from patient entrapment in or around the Side Rails,
restraints or other accessories. In the US, for a description of entrapment hazards, vulnerable patient profile and
guidance to further reduce entrapment risks, refer to FDA’s Hospital Bed System Dimensional and Assessment
Guidance To Reduce Entrapment. Outside the US, consult the local Competent Authority or Government Agency
for Medical Device Safety for specific local guidance. Consult a caregiver and carefully consider the use of
bolsters, positioning aids or floor pads, especially with confused, restless or agitated patients. It is recommended
that Side Rails (if used) be locked in the full upright position when patient is unattended. Make sure a capable
patient knows how to get out of bed safely (and, if necessary, how to release the Side Rails) in case of fire or other
emergency. Monitor patients frequently to guard against patient entrapment.
When selecting a standard mattress, ensure the distance between top of Side Rails (if used) and top of mattress
(without compression) is at least 8.66 in (220 mm) to help prevent inadvertent bed exit or falls. Consider individual
patient size, position relative to the top of the Side Rail) and patient condition in assessing fall risk.
Skin Care – Monitor skin conditions regularly, especially at bony prominences and areas where moisture or
incontinence may occur or collect, and consider adjunct or alternative therapies for high acuity patients. Early
intervention may be essential to preventing serious skin breakdown.
Fluids –Avoid spilling fluids on Air Supply Unit. If spills do occur, clean fluids from bed and Air Supply Unit wearing
rubber gloves to avoid possibility of shock. Once fluid is removed, check operation of components in area of spill.
NOTE: Fluids remaining on controls can cause corrosion, which may cause components to fail or operate
erratically, possibly producing potential hazards to patient and caregiver.
Lock-Outs –Lock-out feature on Air Supply Unit should be used at caregiver’s discretion to ensure against
unintentional or unauthorized tampering with unit settings.
Avoid Fire Hazards –To minimize risk of fire, connect bed’s Power Cord directly into a wall-mounted outlet. Do
not use extension cords or multiple outlet strips. Review and follow FDA’s Safety Tips for Preventing Hospital Bed
Fires (dated 12/18/03).
No Smoking in Bed –Smoking in bed can be dangerous. To avoid risk of fire, smoking in bed should never be
allowed.
Tobacco Smoke – If routine laundering and cleaning procedures (as described in Preventive Maintenance
section in the Maintenance chapter of the First Step Select Maintenance Manual) are not followed, tobacco
smoke build-up may conceivably reduce amount of air flow through product. Severe air restrictions (whatever the
source) may cause Air Supply Unit to overheat and automatically deactivate.

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Power Cord –Ensure Power Cord is kept free from all pinch points and moving parts, and is not trapped under
casters. Improper handling of Power Cord can cause damage, which may possibly produce risk of fire or electrical
shock.
General Protocols –Follow all applicable safety rules and institution protocols concerning patient and caregiver
safety.

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2
PATIENT PLACEMENT
Carefully read Contraindications, Risks and Precautions and Safety Tips sections in the Introduction chapter
of this manual prior to performing patient placement on First Step Plus.
PREPARING FOR PATIENT PLACEMENT
1. Level bed and lock caster wheel brakes and caster wheel steering.
NOTE: Always use standard hospital bed frame and any other safeguards that may be appropriate.
Side Rails should be locked in full upright position whenever patient is left unattended.
2. Install Overlay:
•Place tote bag at foot of mattress.
•Open tote bag and remove Overlay, Air Hoses, Air Supply Unit, sheets etc.
•Place Overlay on mattress with hose connections and tote bag at foot of mattress with elastic harness on
underside of Overlay.
•Slide elastic harness over each end of mattress.
•Tuck tote bag under foot-end of mattress.
•Wrap elastic halter straps (located at each end of Overlay) under and around end of bed mattress.
3. Install First Step Plus nylon fabric with moisture vapor permeable backing Cover Sheet:
•Draw sides of Sheet down each side of bed and tuck under mattress.
•Secure Sheet around hose connections using individual hook and loop strips located on Cover Sheet.
4. Install Air Supply Unit:
•Swing out adjustable hanging arms located on each side of Air Supply Unit.
•Pull down Tilt Display Bracket located on lower backside of Air Supply Unit.
•Hang Air Supply Unit on footboard of bed.
NOTE: Verify air intake (located on back face of Air Supply Unit) is not blocked by blanket or other
obstructions. Air Supply Unit has thermal cutoff that will automatically deactivate unit, after a
period of time, if air intake is blocked.

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5. Attach hoses to Air Supply Unit:
•Locate Hose Set Coupler that holds three hose ends together.
•Turn Hose Set Coupler so that hoses are stacked vertically and blue HEAD
hose is on top.
•Insert top tab of Coupler into horizontal slot on right side of Air Supply Unit.
Pivot Coupler downward, placing hose ends over air outlets until bottom of
Coupler clicks into locked position.
NOTE: Ensure hose set is not twisted.
6. Attach hoses to Air Cushion:
•Match color-coded hose ends to their respective patches on Air Cushions.
•Attach hoses snugly by slightly turning while pushing hose end onto Overlay hose connectors.
7. Plug Air Supply Unit into 115 VAC wall outlet.
NOTE: Verify power to this outlet IS NOT controlled by a wall switch.
8. Activate Air Supply Unit by depressing green Power Button.
9. Adjust Head, Body and Foot air flow control knobs (located on front of Air Supply Unit) to a low setting.
10. Transfer patient, as described below:
PATIENT TRANSFER TO FIRST STEP PLUS
Ambulatory Patient Transfer
1. Adjust height of both surfaces to ensure patient comfort for ingress and egress.
2. Lower Side Rails (when applicable).
3. Lock caster wheel brakes and caster wheel steering on both surfaces.
4. Assist patient in ambulatory transfer, following all applicable safety rules and institution protocols.
5. Center patient side-to-side on surface. Patient’s sacrum should be centered head-foot on seat section cushion.
6. Raise and lock Side Rails on both sides of bed, if decision has been made to use Side Rails. (Refer to Risks
and Precautions and Safety Tips sections in the Introduction chapter of this manual.)
7. Adjust air flow control knobs to the proper inflation for individual patient. (See Air Pressure Adjustment
section on following page.)
8. Check for proper patient placement; slide hand flat between bottom of underlying surface and patient’s
buttocks. There should be 1 in to 1.50 in clearance between patient and underlying surface.
9. With air pressures set, verify patient comfort.
10. Lower bed height to lowest level.
11. Activate Warmer and adjust temperature, if desired.

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Non-Ambulatory Patient Transfer
1. Press green Power Button on Air Supply Unit to activate Blower.
2. Adjust air flow control knobs to fully inflate each individual cushion. (See Air Pressure Adjustment section
below.)
3. Adjust height of bed to same level as surface from which patient is being transferred.
4. Lock caster wheel brakes and caster wheel steering on both surfaces.
5. Lower Side Rails (when applicable).
6. Transfer patient, following all applicable safety rules and institution protocols.
7. Center patient side-to-side on First Step Plus surface. Patient’s sacrum should be centered head-foot on seat
section cushion.
8. Adjust air flow control knobs to proper inflation for individual patient. (See Air Pressure Adjustment section
below.)
9. Raise and lock Side Rails on both sides of bed, if decision has been made to use Side Rails. (Refer to Risks
and Precautions and Safety Tips sections in the Introduction chapter of this manual.)
10. With air pressures set, verify patient comfort.
11. Lower bed height to lowest level.
12. Activate Warmer and adjust temperature, if desired.
AIR PRESSURE ADJUSTMENT
1. Adjust air flow to each section (head, body and feet) by turning respective air flow control knob. Knobs are
labeled and color-coded.
NOTE: Verify air intake (located on back face of Air Supply Unit) is not blocked by blanket or other
obstructions. Air Supply Unit has thermal cutoff that will automatically deactivate unit, after a period of
time, if air intake is blocked, or if unit is operated with all three air flow control knobs in OFF position. If
temporary discontinuance of air flow is desired, press green Power Button.
NOTE: Large adjustments in air pressure to one section of Mattress Overlay may prompt re-adjustment to a
different section of Overlay.
2. To assist in patient comfort, allow cradling effect or slight depression in
Overlay where patient lies.
3. Check for proper patient placement; slide hand flat between First Step Plus
and bed mattress, under patient’s buttocks. There should be 1 in to 1.50 in
(2.50 cm to 4 cm) space of inflated Overlay between patient and bed
mattress.
4. If head of bed is to be elevated, it may be necessary to increase air flow to
BODY section to ensure proper support.

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COMPLETION OF PATIENT PLACEMENT
1. Adjust head of bed for patient comfort.
2. With air pressures set, verify patient comfort.
3. Lower bed height to lowest level.
4. Activate Warmer and adjust temperature, if desired.
5. Verify caster wheel brakes and caster wheel steering are locked.
6. Assess entrapment and fall hazards, and carefully consider use of bolsters, positioning aids, low beds, floor
pads or padded Side Rail accessories when appropriate, especially with confused, restless or agitated
patients. (Refer to Risks and Precautions and Safety Tips sections in the Introduction chapter of this
manual.)
7. It is advised that capable patients are instructed on how to release Side Rails and exit bed in case of
emergency.

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3
NURSING CARE
Carefully read Contraindications, Risks and Precautions and Safety Tips sections in the Introduction chapter
of this manual prior to performing nursing care for patient on First Step Plus.
CPR
In the event CPR procedures are required:
1. Lift up on Quick Release Lever.
2. Swing Hoses away from Air Supply Unit.
3. Bring bed to a level position. Lower Side Rails.
4. Place back board under patient.
5. Begin CPR. Patient’s body weight and the CPR process will deflate Mattress
Overlay.
6. After CPR is performed and patient is clinically stable:
•Return Side Rails, restraints and other accessories to original positions. (Refer to Safety Tips section.)
PATIENT TRANSFER TO FIRST STEP PLUS
Refer to Patient Placement chapter of this manual if patient is being transferred to First Step Plus for first time.
PATIENT TRANSFER FROM FIRST STEP PLUS
Ambulatory Patient Transfer
1. Press green Power Button to turn OFF Air Supply Unit. Surface will begin to deflate.
2. Adjust height of bed to same level as the surface to which patient is being transferred.
3. Lock caster wheel brakes and caster wheel steering on both surfaces.
4. Lower Side Rails.
5. Transfer patient, following all applicable safety rules and institution protocols.
Non-Ambulatory Patient Transfer
1. Adjust all three air flow control knobs to increase pressure in cushions, to create a firm surface for patient
transfer.
2. Adjust height of bed to same level as surface to which patient is being transferred.
3. Lock caster wheel brakes and caster wheel steering on both surfaces.
4. Lower Side Rails.
5. Transfer patient, following all applicable safety rules and institution protocols.
Quick Release Lever
R
TM
R
TM
1
2

3-2
PATIENT TRANSPORT
1. Press green Power Button to turn OFF Air Supply Unit. Mattress Overlay will begin to deflate.
2. Unplug Power Cord from wall outlet.
3. Unlock caster wheel brakes and caster wheel steering.
4. Transport patient, following all applicable safety rules and institution protocols.
5. Plug Power Cord into 115 VAC 15 Amp grounded wall outlet when destination is reached.
NOTE: Verify power to this outlet IS NOT controlled by a wall switch.
6. Press green Power Button to turn ON Air Supply Unit. Adjust surface pressures for patient comfort.
PATIENT BATHING
1. When Side Rails are available, raise Side Rails on side of bed opposite caregiver to help reduce risk of patient
fall during bathing.
2. Adjust bed height and level bed to facilitate bathing.
3. Set air pressures in Mattress Overlay to maximum by turning all three air flow control knobs to a high setting to
provide firm surface for patient bathing.
4. Lower Side Rail on caregiver side of bed.
CAUTION
To reduce risk of patient falls during bathing, caregiver must
never leave patient unattended or turn away during bathing.
5. Gently log roll patient toward opposite Side Rail.
6. Bathe and rinse patient’s exposed side and posterior.
NOTE: Avoid spilling fluids on Air Supply Unit. Fluids remaining on controls can cause corrosion, which may
cause components to fail or operate erratically, possibly producing potential hazards to patient and
caregiver.
7. Wipe Cover Sheet while bathing patient. Cover Sheet will dry quickly from air flow through fabric.
NOTE: Replace and launder extensively soiled Cover Sheet and cushions.
8. Return patient to supine position in center of surface.
9. Raise and lock Side Rails on both sides of bed, if decision has been made to use Side Rails. (Refer to Risks
and Precautions and Safety Tips sections in the Introduction chapter of this manual.)
10. Repeat Steps 4 - 9 for other side of patient.
11. Adjust all three air flow control knobs to return surface to previous air pressure settings.
12. Adjust head and foot of bed for patient comfort.
13. Adjust Warmer and bed height, as required.

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BEDPAN PLACEMENT
1. Adjust bed height and level bed to facilitate bedpan placement.
2. Reduce pressure in center cushion.
3. Lower Side Rail on caregiver side of bed.
4. When Side Rails are available, raise Side Rail on side of bed opposite caregiver to help reduce risk of patient
fall during bedpan placement.
5. Gently log roll patient toward opposite side of bed.
6. Position bedpan underneath patient by pushing bedpan down into surface.
7. Gently roll patient onto bedpan, keeping one hand on bedpan until patient is in position.
8. Raise and lock Side Rails on both sides of bed, if decision has been made to use Side Rails. (Refer to Risks
and Precautions and Safety Tips sections in the Introduction chapter of this manual.)
9. Adjust head of bed for patient comfort and return bed and accessories to original configuration.
BEDPAN REMOVAL
1. Lower head of bed to a level position.
2. Lower Side Rail on caregiver side of bed.
3. Grasp bedpan firmly with one hand. Using other hand, gently roll patient toward opposite side of bed.
4. Remove bedpan by pushing bedpan down into surface and slide away from patient.
5. Cleanse and dry patient’s skin.
6. Return patient to proper placement on mattress.
7. Raise and lock Side Rails on both sides of bed, if decision has been made to use Side Rails. (Refer to Risks
and Precautions and Safety Tips sections in the Introduction chapter of this manual.)
8. Return pressure in center cushion to previous setting.
9. Adjust head of bed for patient comfort and return bed and accessories to original configurations.

3-4
REPOSITIONING PATIENT USING DRI-FLO UNDERPADS
1. Adjust bed to lowest height position.
2. Adjust all three air flow control knobs to increase pressure in cushions, to create a firm surface for patient
repositioning.
3. When Side Rails are available, lower Side Rail on caregiver side of bed.
4. Position one caregiver on each side of patient; at least two people will be needed. Roll edges of Dri-Flo on
each side of patient to provide a firm grip.
5. Use Dri-Flo Underpad to lift and reposition patient.
6. Raise and lock Side Rails on both sides of bed, if decision has been made to use Side Rails. (Refer to Risks
and Precautions and Safety Tips sections in the Introduction chapter of this manual.)
7. Adjust all three air flow control knobs to return surfaces to previous air pressure settings.
8. Adjust head of bed for patient comfort and return bed and accessories to original configurations.
INCONTINENCE / DRAINAGE
1. First Step Plus nylon fabric with moisture vapor permeable backing Cover Sheet should be placed over
Mattress Overlay.
2. Dri-Flo Underpads are recommended for incontinent patients.
NOTE: Do not use plastic-backed underpads; plastic will block moisture vapor transmission and air flow from
Mattress Overlay. Dri-Flo Breathable Underpads are absorbent and do not block air flow.
3. Watch for incontinence or drainage, and provide meticulous skin care following each episode.
SKIN CARE
1. Remove excess moisture and keep patient's skin clean and dry.
2. Maintain proper air pressures in accordance with Air Pressure Adjustment section in the Patient Placement
chapter of this manual.
3. Monitor patient's skin condition regularly, especially at bony prominences and in areas where incontinence and
drainage occur and collect.
4. Consider adjunct or alternative therapies for high acuity patients.
GENERAL OPERATION
Avoid contact of sharp instruments with First Step Plus.
Punctures, cuts and tears may prevent proper inflation and air pressure operation.

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4
CARE AND CLEANING
The following are ArjoHuntleigh’s recommended daily and weekly cleaning and infection control procedures for
First Step Plus while in use. If this product is to be purchased, or utilized for long term rentals, it is recommended
that manufacturer’s Infection Control Procedures be utilized by facility, dealership or home user. Contact local
manufacturer’s representative for details.
Carefully read Contraindications, Risks and Precautions and Safety Tips sections in the Introduction chapter
of this manual prior to performing care and cleaning procedures on First Step Plus.
Follow all regulations, outlined in OSHA Occupational Exposure to Bloodborne Pathogens 29 CFR 1910.1030,
regarding Infection Control Procedures to be used when cleaning First Step Plus.
DAILY CARE AND CLEANING OF FIRST STEP PLUS WHILE IN USE
NOTE: Patient does not need to be removed from First Step Plus when performing daily cleaning procedures.
Patient may be bathed as patient support surface is being cleaned.
1. Raise and lock Side Rails on both sides of bed, if decision has been made to use Side Rails. (Refer to Risks
and Precautions and Safety Tips sections in the Introduction chapter of this manual.)
2. Inflate surface fully by adjusting all three air flow control knobs to their highest settings.
3. If Side Rails are used, lower Side Rail only on caregiver side of bed.
4. Log roll patient to opposite side of surface.
5. Clean patient, as required.
NOTE: Avoid spilling fluids on Air Supply Unit. Fluids remaining on controls can cause corrosion, which may
cause components to fail or operate erratically, possibly producing potential hazards to patient and
caregiver.
6. Wipe Cover Sheet, as required, with soap and water or approved hospital germicide.
7. Move Cover Sheet for access and wipe soiled Mattress Overlay, as required. Replace and launder
extensively soiled Cover Sheet or Mattress Overlay.
8. Dry surface and Cover Sheet with towel. Remaining moisture will evaporate rapidly with air flow.
9. Move Cover Sheet back into position.
10. Move patient to clean, dry side of surface and repeat Steps 4 - 11 on opposite side.
11. Return patient to center of surface.
12. Return surface to previous air pressure settings.
WEEKLY CARE AND CLEANING OF FIRST STEP PLUS WHILE IN USE
In addition to daily care and cleaning described above, First Step Plus Cover Sheet should be replaced weekly or
more often, as needed. Excessively soiled Mattress Overlay and Cover Sheet should be replaced and laundered,
as described in Infection Control section in the Preparation for Use chapter of the First Step Plus Maintenance
Manual.

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5
OPERATING INSTRUCTIONS
Review Safety Tips section in the Introduction chapter, as well as Preparing for Patient Placement section in
the Patient Placement chapter of this manual before beginning operation of First Step Plus.
POWER-UP PROCEDURE
1. Plug Air Supply Unit into 115 VAC wall outlet.
NOTE: Verify power to this outlet IS NOT controlled by a wall switch.
2. Press green Power Button to activate Air Supply Unit.
NOTE: Motor will ramp-up, setting pressures during first 25 seconds of
operation. After ramping up and setting pressures, unit will be
noticeably quieter.
PRESSURE ADJUST
1. Adjust air flow to each section (head, body and feet) by turning respective air
flow control knob. Knobs are labeled and color-coded.
2. Adjust each surface control knob until optimum pressures and patient
comfort has been obtained.
3. Adjust air flow so patient is cradled in a slight depression.
NOTE: Air Supply Unit has a thermal cutoff that will automatically
deactivate unit, after a period of time, if air intake is blocked, or if unit
is operated with all three air flow control knobs in OFF position.
4. If temporary discontinuance of air flow is desired, green Power Button
should be used.
WARMER ADJUST
1. Patient warming is controlled by Warmer control knob located on top of Air
Supply Unit.
2. Turn Warmer control knob clockwise to increase Warmer setting.
NOTE: Do not use Warmer with all three air flow control knobs in OFF
position.
3. If Warmer is used, speed patient warming by temporarily increasing air flow
to FEET section.
Po w e r Sw i t c h
TM
R
He a d
(Blue )
Body
(Gre e n)
Feet
(Red )

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6
SPECIFICATIONS*
Maximum Patient Weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250 lb
Dimensions:
Mattress Overlay (Inflated) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 in L x 35 in W x 5 in H
Air Supply Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 in L x 10.75 in H x 7 in D
Weight:
Mattress Overlay (Inflated) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 lb
Air Supply Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 lb
Electrical:
Voltage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 VAC
Frequency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Hz
Power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.5 Amps
Maximum Electrical Leakage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Micro Amps
Power Cord . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 ft Hospital Grade
* Specifications subject to change without notice.

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7-1
GETINGE GROUP is a leading global provider of products and systems that
contribute to quality enhancement and cost efficiency within healthcare and life
sciences. We operate under the three brands of ArjoHuntleigh, GETINGE and
MAQUET. ArjoHuntleigh focuses on patient mobility and wound management
solutions. GETINGE provides solutions for infection control within healthcare and
contamination prevention within life sciences. MAQUET specializes in solutions,
therapies and products for surgical interventions and intensive care.
7
QUESTIONS AND INFORMATION
For questions regarding First Step Plus, supplies, maintenance or additional information about ArjoHuntleigh
products and services, please contact ArjoHuntleigh or an ArjoHuntleigh authorized representative or visit
www.ArjoHuntleigh.com
In the US, call 1-800-343-0974.
Originally:
Manufactured by / for KCI USA, Inc.
Currently:
Manufactured for:
ArjoHuntleigh AB
Hans Michelsensgatan 10
211 20 Malmö, Sweden
® and ™ are trademarks belonging to the ArjoHuntleigh group of companies
© ArjoHuntleigh 2013. P/N 200676-AH Rev A